COVID-19 and Suicide: Prioritizing Our Well-Being

Over the last couple of months, COVID-19 has dramatically altered our norms and routines. As we each do our part to fight the spread of this virus by staying home and washing our hands, it is also an important time to focus on our social and emotional well-being. This was highlighted in a recent town hall about the pandemic in which President Trump suggested that continued social distancing would lead to “suicides by the thousands” in the U.S., due in part to economic distress. Though presented inaccurately, this comment raised concerns in the media and the public.

What the Data Say

When it comes to national suicide rates, two things are simultaneously true. First, data show that suicide rates can increase during times of economic distress (Chang et al., 2013; Reeves et al., 2012). For example, we saw increased rates of suicide during the Great Depression era and research shows that economic hardship and poverty are associated with increased suicide rates. Second, data also show that suicide rates can decrease during times of national crisis (Joiner, 2005; Lester, 1994). For example, we saw lower rates of suicide during World War II and immediately following the terrorist attacks on September 11, 2001. Recent news pieces across the political spectrum have attempted to compare the current pandemic situation to these times in order to forecast how suicide rates might be impacted. The short answer is we don’t know.

The COVID-19 pandemic cannot easily be compared to the economic instability of the Great Depression or the social connectedness of the World War II era. It is neither an economic crisis nor a social crisis. Rather, it is an unprecedented situation that lies somewhere in between.

Suicide is multi-faceted, and two factors are relevant to discuss here: economic instability and social connectedness. Economically, we are in a similar situation to the Great Depression era with unemployment and financial insecurity soaring across the country. This can certainly contribute to suicide risk, and multiple studies demonstrate this. Socially, we are more connected as a society than ever before, and there is a sense of camaraderie that stems from a common crisis and shared experience of a crisis—both of which can reduce suicide risk. Many studies demonstrate this as well.

What the Research Says

One way to view these seemingly incongruous findings is through the lens of the Interpersonal Theory of Suicide. This is the leading theory in the field of suicidology and was developed by Thomas Joiner in 2005. The theory posits that there are three factors that must converge in order for death by suicide to occur:

· Thwarted belongingness (a lack of belonging or feeling alone)

· Perceived burdensomeness (feeling as though one is a burden to others), and

· The acquired capacity to enact self-harm (overcoming the inclination toward self-preservation in order to harm oneself).

Times of economic instability can increase perceived burdensomeness by increasing reliance on social safety nets and loved ones and being unable to meet one’s basic needs. Not being able to provide for one’s family and overwhelming stress can also exacerbate these feelings. This likely explains increased rates during economic uncertainty.

On the other hand, in times of national crisis such as wartime and natural disasters, thwarted belongingness tends to decrease due to a sense of camaraderie and feelings of being “in this together.” Many people feel a sense of duty for the common good (be it patriotism or public health), which adds to a sense of purpose and can decrease perceived burdensomeness in people. These likely explain reduced rates during national crises.

Our current situation is unprecedented and there are no data on this particular situation to compare to. Some research suggests that suicide rates increased during the Great Influenza Epidemic in the United States between 1918 and 1920 (Wasserman, 1992). However, data are hard to come by, the global and national economy looked different, and the social landscape was different.

What it Means

The main point takeaway from the research is that we simply do not know how the current pandemic might influence suicide rates. As such, stating that rates will either increase or decrease is inaccurate. In particular, though, stating that rates may increase in any sort of definitive way can be dangerous because it increases anxiety and stokes fear. In addition, research demonstrates that talking about suicide as something that is inevitable can normalize it and present it as an option for people, which could then increase rates.

From an epidemiological perspective, returning to business as usual too soon to alleviate economic strain will prolong the duration of the virus, can create another uptick in cases, and therefore extend both the economic and social ramifications of COVID-19. Moreover, physicians have higher rates of burnout, depressive symptoms, and suicide risk than the general population. Therefore, it is more important than ever to follow the CDC’s guidelines for social distancing and hygiene in order to flatten the curve of infection and decrease the burden on our healthcare systems.

Suicide is a complex issue impacting tens of thousands of Americans each year. Therefore, it is imperative that we prioritize physical, social, and emotional health in these times. As a country, prioritizing economic stability over social and emotional well-being is dangerous. Prioritizing markets over people is dangerous. Our elected officials must promote the general welfare for everyone. Anything less is negligent and irresponsible.

If you or someone you know is struggling with thoughts of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255 or text the word TALK to 741-741. Know that help and resources are available, and you are never alone.

Corbin J. Standley is a Ph.D. Student in Ecological-Community Psychology. Read and learn more about his work at www.CorbinJStandley.com.